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OS030. Hypertension and labor duration: Does it take longer?
J M Bregand-White1, M Kominiarek1, J U Hibbard1
1Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, United States.
Pregnancy Hypertension
|June 25, 2015
Summary
Hypertensive disorders in pregnancy affect labor progression differently. Gestational hypertension shortened labor, while chronic hypertension and superimposed preeclampsia prolonged it, suggesting potential for reduced cesarean rates with longer labor allowance.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Reproductive Health
Background:
- Hypertensive disorders in pregnancy are linked to increased maternal and fetal risks, often necessitating labor induction.
- Previous research suggested preeclampsia accelerates labor, but data on other hypertensive conditions is limited.
- One study indicated prolonged labor and higher cesarean rates in preeclamptic women.
Purpose of the Study:
- To investigate and compare labor progression in term nulliparas undergoing induction for various hypertensive disorders.
- To analyze differences in the first and second stages of labor among women with chronic hypertension, gestational hypertension, preeclampsia, and superimposed preeclampsia compared to controls.
Main Methods:
- Retrospective cohort study utilizing data from the Consortium on Safe Labor, including 32,276 women.
- Analysis focused on singleton, term gestations, induced labor, and vertex presentation.
- Women were categorized into: chronic hypertension (cHTN), gestational hypertension (gHTN), preeclampsia (PreE), superimposed preeclampsia (SIPreE), and controls. Interval-censored regression analyzed labor duration from 4-10cm.
Main Results:
- Significant demographic differences existed between hypertensive groups and controls.
- Women with cHTN and SIPreE experienced longer first-stage labor; gHTN had a shorter first stage.
- Labor duration in PreE was similar to controls. Epidural use prolonged the second stage across groups, with limited clinical significance.
Conclusions:
- Labor progression in induced nulliparas with hypertensive disorders varies significantly.
- Gestational hypertension is associated with the shortest first stage, while preeclampsia shows patterns similar to controls.
- Prolonged first-stage labor in cHTN and SIPreE may offer opportunities to reduce cesarean delivery rates, warranting further investigation.
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